Effect of depressive and ptsd symptoms on risk for tuberculosis disease among mothers and children

The National Institute of Allergy and Infectious Diseases awarded Trustees of Boston University $100,228 on November 11, 2026, under the Allergy and Infectious Diseases Research program (CFDA 93.855) to conduct longitudinal epidemiological research examining how depressive and post-traumatic stress disorder (PTSD) symptoms affect tuberculosis disease risk among mothers and children.

The research will estimate the impact of maternal depressive and PTSD symptoms on TB risk in two cohorts. Aim 1 uses nested case-control design with conditional logistic regression to assess the effect of depressive and PTSD symptoms on TB risk among mothers. Aim 2 applies multivariable Cox proportional hazards regression to estimate how maternal mental health during pregnancy influences child TB disease and infection risk. Data derives from the Drakenstein Child Health Study, a multi-morbidity birth cohort in Western Cape, South Africa, that follows mothers and children from 28 to 32 weeks' gestation through age 10. This award supports the first study to examine how PTSD symptoms predispose individuals to TB development and how maternal mental health during pregnancy influences child TB risk.

Work will be performed in Roxbury, Massachusetts, with data sourced from South Africa. The period of performance extends through June 30, 2028.

Abstract

Tuberculosis (TB) and psychiatric disorders are highly prevalent globally and interconnected through biological and behavioral pathways. Psychiatric disorders are thought to exacerbate TB severity, mortality, drug resistance and risk for disease progression. Among people with TB, an estimated 50% and 30% experience depression and post-traumatic stress disorder (ptsd), respectively. While preliminary evidence suggests that psychiatric symptoms may increase risk of TB, evidence from high-quality longitudinal data sources remains scarce. Furthermore, pregnancy may be a critical period when mental health service integration can reduce TB incidence among mothers and children. The overall objective of the proposed project is to estimate the impact of depressive and ptsd symptoms on tuberculosis disease risk among mothers and children. Aim 1 will focus on estimating the effect of depressive and ptsd symptoms on TB risk among mothers. Aim 2 will focus on estimating the effect of maternal depressive and ptsd symptoms during pregnancy on child risk for TB disease and infection. Data will come from the drakenstein child health study (dchs), a multi-morbidity birth cohort in western cape, south africa, which follows mothers and children from 28-32 weeks' gestation through age 10. Aim 1 will use a nested case-control design with conditional logistic regression and aim 2 will use multivariable COX proportional hazards regression. This will be the first study to examine how ptsd symptoms predispose people to developing TB and how maternal mental health during pregnancy influences TB risk in children. Understanding how psychiatric disorders impact susceptibility to TB disease and infection will lay the foundation for research on strategic mental health screening and interventions to achieve TB reduction and elimination. This research aligns with niaid's mission to advance understanding of infectious diseases to inform response to reemerging disease threats, including the 2026 council-approved focus on the role of comorbidities on TB disease progression. My mentoring team has outstanding expertise in TB epidemiology, psychiatric epidemiology, and biostatistical methods, and is fully committed to supporting me in my training and professional development. We have designed a training plan which includes coursework and workshops in psychiatric and TB epidemiology, career development, and mentored research. Through this fellowship, i will develop the skills to become an independent researcher at the intersection of mental health and infectious disease.